Suneel Kumar Punjabi, Kashif Ali Channar, Munir Ahmed Banglani, Naresh Kumar, Ambreen Munir.
Isolated zygomatic bone fracture; management by three point fixation.
Professional Med J Jan ;23(05):526-30.

Introduction: Facial bones injuries results in functional disturbances. Patients may presents with flattening of normal malar prominence, lid drop, eye movement limited or with double vision, numbness of cheek area and unilateral epitasis. Emphasizing upon incision type, fixation method and occasionally reconstruction, surgeons suggest different methods for repairing complex fractures of Zygoma. Study Design: Descriptive study. Setting: Department of Oral & Maxillofacial Surgery, Liaquat University of Medical & Health Sciences, Jamshoro. Period: Mar 2013 to Feb 2014. Materials and methods: Total 20 patients were included. Patients with fracture more than 28 days old were excluded. Zygomatic bone can be approached by lateral brow or subcilicary incisions and by subgingival buccal sulcus approach. When 3 fracture sites were reduced and aligned satisfactorily, application of miniplates was performed at 3 points frontozygomatic suture, Zygomatico maxillary buttress and infraorbital rim, wound were closed in 2 layers. At 2nd week follow-up patients were assessed for outcome. Results: There were 14 male and 6 female patients. Most were of age <25 years. 45% fractures were due to RTA. Duration of fracture of 2 patients was 2 days, 7 days of 11 patients, 4 patients had 14 days and 3 patients had 28 days. 5 fractures were reduced using Gilies temporal approach, 6 with Keen approach, 4 with Hook approach and 5 with Dingman approach. Preoperatively, 17 patients had facial asymmetry, 19 had limited mouth opening and postoperatively this was reduced to 6 cases each for facial asymmetry and limited mouth opening. Conclusion: It is concluded from this study that three point fixation is most effective and safe method for reduction of fracture of Zygomatic bone.

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